Diabetes, gender, and left ventricular structure in African-Americans: The atherosclerosis risk in communities study

被引:9
作者
Foppa M. [1 ]
Duncan B.B. [1 ,2 ]
Arnett D.K. [3 ]
Benjamin E.J. [4 ]
Liebson P.R. [5 ]
Manolio T.A. [6 ]
Skelton T.N. [7 ]
机构
[1] Graduate Studies Program in Cardiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre
[2] Department of Epidemiology, University of North Carolina, Chapel Hill, NC
[3] Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
[4] Evans Department of Medicine, Boston University, School of Medicine, Boston, MA
[5] Section of Cardiology, Rush Medical College, Rush University Medical Center, Chicago, IL
[6] Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, MD
[7] University of Mississippi Medical Center, MI
关键词
Wall Thickness; Left Ventricular Hypertrophy; Left Ventricular Mass; Relative Wall Thickness; Left Ventricular Geometry;
D O I
10.1186/1476-7120-4-43
中图分类号
学科分类号
摘要
Background: Cardiovascular risk associated with diabetes may be partially attributed to left ventricular structural abnormalities. However, the relations between left ventricular structure and diabetes have not been extensively studied in African-Americans. Methods: We studied 514 male and 965 female African-Americans 51 to 70 years old, in whom echocardiographic left ventricular mass measurements were collected for the ARIC Study. In these, we investigated the independent association of diabetes with left ventricular structural abnormalities. Results: Diabetes, hypertension and obesity prevalences were 22%, 57% and 45%, respectively. Unindexed left ventricular mass was higher with diabetes in both men (238.3 ± 79.4 g vs. 213.7 ± 58.6 g; p < 0.001) and women (206.4 ± 61.5 g vs. 176.9 ± 50.1 g; p < 0.001), respectively. Prevalence of height-indexed left ventricular hypertrophy was higher in women while increased relative wall thickness was similar in men and women. Those with diabetes had higher prevalences of heightindexed left ventricular hypertrophy (52% vs. 32%; p < 0.001), and of increased relative wall thickness (73% vs. 64%; p = 0.002). Gender-adjusted associations of diabetes with left ventricular hypertrophy (OR = 2.29 95%CI:1.79-2.94) were attenuated after multiple adjustments in logistic regression (OR = 1.50 95%CI:1.12-2.00). Diabetes was associated with higher left ventricle diameter (OR = 2.13 95%CI:1.28-3.53) only in men and with higher wall thickness (OR = 1.89 95%CI:1.34-2.66) only in women. Attenuations in diabetes associations were frequently seen after adjustment for obesity indices. Conclusion: In African-Americans, diabetes is associated with left ventricular hypertrophy and, with different patterns of left ventricular structural abnormalities between genders. Attenuation seen in adjusted associations suggests that the higher frequency of structural abnormalities seen in diabetes may be due to factors other than hyperglycemia. © 2006 Foppa et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 38 条
[1]  
Galderisi M., Anderson K.M., Wilson P.W.F., Levy D., Echocardiographic evidence for a existence of a distinct cardiomyopathy (The Framingham Heart Study), Am J Cardiol, 68, pp. 85-89, (1991)
[2]  
Lee M., Gardin J.M., Lynch J.C., Smith V.-E., Tracy R.P., Savage P.J., Szklo M., Ward B.J., Diabetes mellitus and echocardiographic left ventricular function in free-living elderly men and women: The Cardiovascular Health Study, Am Heart J, 133, pp. 36-43, (1997)
[3]  
Vakili B.A., Okin P.M., Devereux R.B., Prognostic implications of left ventricular hypertrophy, Am Heart J, 141, pp. 334-341, (2001)
[4]  
Liao Y., McGee D.L., Cao G., Cooper R.S., Black-white differences in disability and morbidity in the last years of life, Am J Epidemiol, 149, pp. 1097-1103, (1999)
[5]  
Levy D., Echocardiographically detected left ventricular hypertrophy: Prevalence and risk factors. The Framingham Heart Study, Ann Intern Med, 108, pp. 7-13, (1988)
[6]  
Gardin J.M., Arnold A., Gottdiener J.S., Wong N.D., Fried L.P., Klopfenstein H.S., O'Leary D.H., Tracy R., Kronmal R., Left ventricular mass in the elderly. The Cardiovascular Health Study, Hypertension, 29, pp. 1095-1103, (1997)
[7]  
Devereux R.B., Roman M.J., De Simone G., O'Grady M.J., Paranicas M., Yeh J.L., Fabsitz R.R., Howard B.V., Relations of left ventricular mass to demographic and hemodynamic variables in American Indians: The Strong Heart Study, Circulation, 96, pp. 1416-1423, (1997)
[8]  
Liebson P.R., Grandits G., Prineas R., Dianzumba S., Flack J.M., Cutler J.A., Grimm R., Stamler J., Echocardiographic correlates of left ventricular structure among 844 mildly hypertensive men and women in the Treatment of Mild Hypertension Study (TOMHS), Circulation, 87, pp. 476-486, (1993)
[9]  
Zabalgoitia M., Ur Rahman S.N., Haley W.E., Oneschuk L., Yunis C., Lucas C., Yarows S., Krause L., Amerena J., Impact of ethnicity on left ventricular mass and relative wall thickness in essential hypertension, Am J Cardiol, 81, pp. 412-417, (1998)
[10]  
Fox E., Taylor H., Andrew M., Han H., Mohamed E., Garrison R., Skelton T., Body mass index and blood pressure influences on left ventricular mass and geometry in African Americans: The Atherosclerotic Risk in Communities (ARIC) Study, Hypertension, 44, pp. 55-60, (2004)